A Secure Unit for Psychiatric Treatment and Rehabilitation

Page 1

A Secure Unit for Psychiatric Evaluation and Rehabilitation A THESIS Submitted by

Sruthi Raguraj 311213251093 In partial fulfilment of the requirements for the award of the degree of

BACHELOR OF ARCHITECTURE ANNA UNIVERSITY

MARG INSTITUTE OF DESIGN AND ARCHITECTURE SWARNABHOOMI Velur Village, Cheyyur Post Kanchipuram District Tamil Nadu - 603302 MAY 2018


DECLARATION I declare that this Thesis titled

A Secure Unit for Psychiatric Evaluation and Rehabilitation is the result of my work and prepared by me under the guidance of Prof. M. Senthil and that work reported herein does not form part of any other thesis of this or any other University. Due acknowledgement has been made wherever anything has been borrowed from other sources.

Date:

Signature of the Candidate :

Name :

Sruthi Raguraj

RollNumber:311213251093

2


BONAFIDE CERTIFICATE Certified that this Thesis forming part of Course work AR2452, Thesis, X semester, B.Arch, entitled

A Secure Unit for Psychiatric Evaluation and Rehabilitation Submitted by Ms. Sruthi Raguraj Roll No. 311213251093 to the Department of Architecture, MARG Institute of Design and Architecture Swarnabhoomi, Anna University, Chennai in partial fulfilment of the requirements for the award of Bachelor Degree in Architecture is a bonafide record of work carried by her under my supervision. Certified further that to the best of my knowledge the work reported herein does not form part of any other thesis. Date: Signature of the Supervisor : Name : Designation :

External Examiner 1

External Examiner 2

Date :

Date :

HOD

PRINCIPAL

MIDAS Date :

MIDAS Date: 3


ABSTRACT This thesis investigates the fact that architecture can have a positive effect on the common attitude towards mentally challenged patients by providing them with an environment suitable for development and initiative. The project analyses the situation of such a forum in the process, that of a psychiatric and rehabilitation facility functioning to change mindsets on either side of the fence by taking patients through a wholesome development programme designed specially to aid them in the real world. It promotes mental health as well as sets up a new forum of public spaces where products and consumers meet. The centre provides a space full of natural atmosphere and vitality; a place that is self-contained and forms a corresponding relationship with the surroundings. It also emphasizes the need for craftsmanship in achieving the same. The project attempts to use an architectural language that is futuristic, reflecting the significance of progress and evolution in mental health for the nation. This thesis proposes the creation of a secure unit aiding rehabilitation of psychiatric patients. The centre emphasises on the importance of encouraging knowledge transfer and understanding. It enables social interactions between people from different cultures, creating valuable connections between communities while reducing social isolation and prejudices. lowering the stigma that surrounds such people. The ultimate goal of the project is to support and rehabilitate psychiatric patients through a wholesome all rounded program. The centre will be imagined as an architecture of progress; a gateway to a better future. 4


ACKNOWLEDGEMENT

Firstly, I am grateful to God for the given intellect, health and wellbeing without which this thesis would not have been brought forth. I would also like to thank my thesis guide Prof. Senthil Mani for his valuable input and timely advice. I would like to express my deepest gratitude to Prof. Ramji and Prof. C.K.Praveen for their guidance and input throughout this project. I would like to express my deepest appreciation for Dr. Bhadrinarayanan MS, NIMHANS and Prof Naveen, NIMHANS for their insight, knowledge and support. I would like to sincerely thank my parents and family for all their encouragement and support. My father for his advice and my mother for her prayers. I would also like to take the opportunity to thank a few of my friends Akshita Arunachalam, Thirumoorthy J, Kiran Raj and juniors Akshaya Prabhu, Harie Krishnan, Gautam. S and Sarah Varghese for all their assistance and advice.

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TABLE OF CONTENTS CHAPTER NO.

1

2

TITLE

PAGE NO.

ABSTRACT

4

ACKNOWLEDGMENT

5

LIST OF FIGURES

8

INTRODUCTION 1.1

INTRODUCTION

10

1.2

BACKGROUND

11

1.3

ISSUES

12

1.4

MOTIVATION

13

1.5

OBJECTIVES

13

1.6

SCOPE

14

1.7

LIMITATIONS

14

1.8

SPECIAL STUDY

15

STUDY & RESEARCH 2.1

LIST OF CASE STUDIES

16

2.2

NIMHANS

17

2.3

VSIMH

21

2.4

BROADMOOR

25

2.5

SITE SELECTION AND ANALYSIS

29

2.6

SPECIAL STUDY

33

6


3

SOLUTION & CONCLUSION 3.1

SITE PLAN

40

3.2

CONCEPT

41

3.3

ADMINISTRATION & CRISIS

42

STABILIZATION UNIT 3.4

FORENSIC UNITS

45

3.5

TREATMENT SPACES

48

3.6

RE-INTEGRATION VILLAGE

61

3.7

DESIGN STUDY

64

CONCLUSION

65

7


LIST OF FIGURES FIGURE NO.

FIGURE NAME

PAGE NO

1.1

Admitting Authorities

11

1.2

Affecting factors

12

1.3

Statistics

14

2.1

NIMHANS entrance

17

2.2

Views of NIMHAN

18

2.3

Plan, NIMHANS

19

2.4

News article NIMHANS

20

2.5

VSIMH Entrance

21

2.6

Zoning of VSIMH

21

2.7

Views of VSIMH

22

2.8

Planning of VSIMH

24

2.9

Site Plan VSIMH

24

2.10

Broadmoor Entrance

25

2.11

Isolation ward view

26

2.12

VSIMH houses chart

26

2.13

Broadmoor Plan

28

2.14

Location of Site

30

2.15

Climatic Study

32

2.16

Shading Devices

35

2.17

Functional flow

37

2.18

Window positioning

38 8


FIGURE NO.

3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24

FIGURE NAME

PAGE NO

Main Block view Site plan Admin GF plan Admin block Admin Sections & Elevation Forensic Unit Plan & View Forensic Female Unit Forensic Male Unit Intermediate Female Block Intermediate Views Intermediate Male Block Chronic Stay Female Block Chronic Stay Views Chronic Male Block Chronic Block Views Acute Care Female ward Acute Care Sections Acute Care Male Block Rehab Centre Plan Rehab Sections 1 BHK 2 BHK VILLA Design study

39 40 42 43 44 45 46 47 48 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

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INTRODUCTION "To not have your suffering recognized is an almost unbearable form of violence" - Andrei Lankov A nation's progress is not just the physical wellbeing of its citizens, but how their psychological health is also looked after. People with behavioural problems need more help from the country. Sadly, our country is lacking in this area. In a country of 1.34 billion people nearly 22,63,821 are mentally challenged. About 80 percent of the country’s psychiatric beds are in the country’s 37 colonial-era “mental hospitals”, draughty, overcrowded, poorly managed constructions, deplorably suited to their anachronistic name. Through the 70s and 80s, these institutions earned press coverage that grew into an indigenous sub-genre of gothic horror. Among the recurring elements were patients being tied up or consigned to dank isolation cells, having little to no access to healthy food and fresh water.There is a high prevalence of psychiatric illness among prisoners lodged in Indian jails and it isn’t surprising that more than half of them had history of substance abuse. According to a study published in the latest edition of the Indian Journal of Psychiatry, the psychiatric morbidity among prisoners is substantially higher than in the general population. Most inmates have several defined problem areas, with substance use, depression and anxiety disorders most prevalent.

10


BACKGROUND “Nothing is an offence, which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.” - Indian Penal Code, 1860

It has been held by the Supreme Court that the law presumes every person of age of discretion to be sane and defence on ground of insanity needs to be proved. If defence is established on ground of insanity, such persons are committed to the Psychiatric Hospitals as per sec 471 (i) of the Cr.P.C., 1973. Sec 89, IPC provides protection for any action done in Fig 1.1 good faith for the benefit of a person of unsound mind by or by consent of the guardian or other person having lawful charge of that person. Sec 305, Indian Penal Code (IPC) provides for punishment of death or imprisonment of life for abetment of suicide by an insane person.

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ISSUES 





There is a high prevalence of psychiatric illnesses among prisoners lodged in Indian jails. According to a study published in the Indian Journal of Psychiatry, the psychiatric morbidity among prisoner is substantially higher than in general population. Most inmates have a number of problem areas with substance abuse, depression and anxiety disorders being the most prevalent. A study conducted by the doctors of Government Medical College, Amritsar and MM College, Haryana found that 23.8% of the inmates had psychiatric problems. These figures are similar to other studies conducted in prisons across the country. The high rate of common psychiatric disorders calls for facilities within or in proximity to the prison compound to diagnose, treat and rehabilitate the inmates.

The asylums of India are modelled on those established during British rule. Their sole purpose is to hide and restrain those unfortunate souls from society, rather than treating their disorders and helping to rehabilitate them. Society always tends to lock up and forget about them. This is more so in the case of prisoners with psychiatric disorders.

Fig 1.2

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MOTIVATION 

 

National

Institute of Mental health and Neurosciences have revealed that at least 13% of the Indian population are suffering from mental health conditions with 10% i.e. approximately 150 million Indians in need of immediate attention. India was one of the first countries to develop a national mental health programme in the 1980’s but no concrete measures were implemented to understand and estimate the spread of mental illnesses in the country. The Parliament passed the Mental healthcare Bill 2016 providing comprehensive legislation for state healthcare facilities, spells out rules and protects the rights of persons with mental illnesses in India. Numerous calls have been made to invoke political will, enhance advocacy, and for galvanizing community participation. With rising awareness in the Indian society, it can be expected that early recognition and access to treatment will follow, as will the adoption of preventative measures.

OBJECTIVES    

To introduce the concept of rehabilitated prisoners, cured from their diagnosed conditions as everyday citizens of society. To diagnose prisoners that have committed crimes and to treat them accordingly with safe and suitable methods as specified with stimulating infrastructure. Rehab patients will have specific treatments, categorized depending on the level of affliction and the crime committed. The facility aims to reintegrate patients into society and their families through the sale of handmade goods thereby instilling a sense of community in the prisoners and aims to lower the stigma surrounding rehabilitated patients.

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SCOPE  

  

A design that appropriately addresses the issues mentioned in the study. A space full of natural atmosphere and flexibility, a place that is self-contained, and forms a corresponding relation with the surroundings. Emphasis on the role of the individual in the process of rehabilitation and on the influence of good spaces. A design that provides affordable access to healthcare as funded by the concerned department of government. The design enables and empowers them to live in a community within the facility as well as the right to confidentiality of treatment.

LIMITATIONS 

Due to the limitation of time and scale of the project the scope will be restricted to certain activities immediately aiding the development of mental health leaving the rest for future development and expansion. Once again due to the limitation of time and scale of the project the proposed design is a model that will only be serving an area within its impact radius. The services such as Electrical, HVAC, Plumbing, Fire System, and Finishes will be considered while designing but not to be detailed. Being a hypothetical proposal maximum research and experimentation is done to achieve the maximum possible. Fig 1.3 14






SPECIAL STUDY To understand a process necessary for a meaningful experiential design approach for an architectural design that affects the mindset of the user. To study and integrate the concept, technology of prefabrication with vernacular materials, construction technology for a unique, easy and quicker method of construction without losing the values & essence of vernacular architecture.

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STUDY & RESEARCH CASE STUDIES : NIMHANS, Bangalore VSIMH, Amritsar Broadmoor, England

SITE SELECTION Site Analysis

SPECIAL STUDY: Climate responsive Designing Work Flow 16


NIMHANS, BANGALORE: LOCATION

: Bangalore

ARCHITECT

: *various*

YEAR OF CONSTRUCTION

: 1925

AREA

:13,221 sq.m

Fig 2.1

Modelled based on Morstley Hospital, London. Upgraded as per needs this hospital specializes in Neurosciences and psychiatry. It helps the patients fund themselves by providing Occupational therapy and Life Training. The National Institute of Mental Health and Neurosciences is a multidisciplinary institute for patient care and academic pursuit in the frontier area of mental health and neuro sciences. The priority gradient adopted at the Institute is service, manpower development and research. A multidisciplinary integrated approach is the mainstay of this institute, paving the way to translate the results from the bench to the bedside. Several national and international funding organisations provide resources for academic and research activities. MATERIALS USED:  Stone and concrete for the older wards. 17




Brick and lime plaster for the newer treatment blocks.

Fig 2.2

PAVILIONS: The various wards are placed around a open courtyard and connected by an open pathway. Aged bricks, concrete and stone give a unique character to each of the blocks at NIMHANS. The age old buildings all have a central courtyard and high load bearing walls and overhangs supported on columns. The lush and green climate responsive design is shown in the following examples: + Open pathways linking blocks amidst green gardens + The various centres are connected through boulevards. + Local materials used. WARDS:  Wall height - 5-6m Reducing accessibility to roof hung fixtures such as fans , lights , etc 18


   

Windows - 4-5m Reducing accessibility to window grill and escape routes. Switch Boards - 4-5m To reduce misuse and self-harm tendencies. Wards - Only Beds provided to prevent self-harm tendencies Bathroom fixtures -As low as possible with minimized projections to prevent self-harm tendencies.

Fig 2.3

CENTRAL COURTYARD: Easy to maintain with drainage and ventilation FORENSIC WARD: Observation Room - For Under trial patients Stay Room - For HC and DC (Currently 2 patients -staying for 6 months) VISITING ROOMS : Near Entrance and first gate DINING ROOM: Serves as a multi-purpose room for occupational therapy and dining COMMON GARDEN: Serves as a therapeutic space under supervision. 19


NURSES’ ROOM: Serves as a treatment room and stay for nurses. SECURITY GATES: It has double security gates for prevention of escape. CASES DEALT WITH: Detention and evaluation of whistle-blower: In December 2014, it was reported that a soldier from the Indian Navy was being held in NIMHANS for a month to evaluate whether he was suffering from mental illness, after acting as a whistle-blower. After the month-long evaluation, NIMHANS concluded that the Navy person was not suffering from any mental illness Negligence of hospital staff regarding mentally disabled man: An intellectually disabled man who was admitted in NIMHANS for treatment was found to have leaped from the terrace of a building. It was reported that he was under round the clock supervision, but escaped without notice. He was found lying in a pool of blood, and was taken to the Emergency Section of the Hospital. Refusal to admit youth to intensive care unit: The New Indian Express reported that the family of a 21-year-old individual who died in NIMHANS complained that their request for him being admitted to the ICU, due to his worsening condition, was declined by the staff. The youth later died, after his condition started to deteriorate.

20


Fig 2.4

Fig 2.5

VSIMH, AMRITSAR LOCATION

: Amritsar 21


ARCHITECT

: Sarbhjit Bhaga

YEAR OF CONSTRUCTION

: 1948

AREA

: 47 acres

Planned on a site of 45 acres, the master plan comprises primarily two zones: • the outer circle • the inner circle.

Fig 2.6

The outer circle accommodates the buildings like 1. OPD-cum-diagnostic-cum-administrative block 2. Occupational therapy/rehabilitation unit 3. Voluntary patients’ unit 4. Serai 5. Shopping / cafeteria 6. Services like kitchen, laundry, and stores 7. Staff quarters

22


Fig 2.7

The inner circle having wards of different types has further been divided in two sections: • The male section on the east • The female section on the west. 1. All the building blocks in the campus have been laid out on a strict cartesian pattern with symmetrical juxtaposition reminiscent of traditional indian campuses. 2. The built-up masses and the open spaces are ingeniously interwoven to create a building-in-the-garden effect. 3. The entire hospital complex has been linked by vaulted corridor running independently through open spaces with greenery on both the sides. 4. Built-up benches have been provided at certain intervals for casual sitting while walking in the corridor. 5. The intersections of two corridors have been developed as a 20 feet by 20 feet chowk with a high roof. 6. The entire inner circle has been kept strictly pedestrian so as to impart serene and tranquil environment to the inmates 7. Vehicular traffic has been restricted to the periphery.

23


8. The designs of all the building blocks have been evolved keeping in view the peculiar requirements of different types of patients. 9. Efforts have been made to evolve a distinctive architecture for each block so as to make them easily identifiable by the inmates. 10. However, the unity and consistency–the two important aspects of campus designing–have been taken care of by providing uniform external finishes i.e., exposed concrete and red sandstone cladding. 11. The master plan provides for ample open spaces to be developed as gardens, parks, play fields, etc. this helps in creating a lively, cheerful, and natural environment, which is a prerequisite for such hospitals.

NUMBER OF BEDS

A mental hospital is a specialty hospital, with its patients having their special needs. broadly, the

patients can be acutely disturbed and excited, or behaviourally settled. Most of the patients are mobile, and, therefore, need more open space. Average stay of patients in a mental hospital is usually much longer than their counterparts in other hospitals, and they frequently suffer from 24


social stigma and face problems in rehabilitation on discharge.

Fig 2.8

PLAN :

Fig 2.9

25


BROADMOOR, ENGLAND LOCATION

: England

ARCHITECT

: N.A.

YEAR OF CONSTRUCTION

: 1863

AREA

: N.A.

Fig 2.10

Broadmoor Hospital is the best known of the three high-security psychiatric hospitals in England. It provides a specialist service assessing and treating men from the south of England who have serious mental health or personality disorders. The highly structured environment requires lighting which reduces risk and promotes safety. The hospital opened in 1863 and was first named the Broadmoor Criminal Lunatic Asylum. However, mental health care has advanced tremendously and the Victorian architecture no longer offers fit for purpose accommodation and care appropriate for the high secure services required in the present day. 26


The act of 1863 with its innovating notion of separating criminal from non-criminal lunatics was what formed the basis for the construction of Broadmoor in Crowthorne, Berkshire. The Broadmoor “Criminal lunatic asylum” (as it was first called, was designed by Major General Joshua Jebb, a military engineer who had previously designed Pentonville Prison (Taylor, 1991, 160). According to the Commissioners in Lunacy, the institution would be: A Lunatic Asylum, A Convict Prison for criminal lunatics, and a Hospital. Broadmoor changed from institution to hospital after the1948 Criminal Justice Act. And also in 1948 the staff’s titles changed from Attendant to Nurse. The locked up regime, where the patients were locked in their rooms from evening till morning, was abolished six years ago. Now they are under what is called a “twenty-four hour therapeutic care”, which means that patients have keys to their

rooms and are free to move about in the ward. Giving more freedom to the patients implies that more staff is needed to do the controlling part. Patients spend most of their time in the common rooms within the wards and have access to toilets at all times.

Fig 2.11

Fig 2.12 27


Kent House is a three storey high building comprising 3 identical wards, one on each floor. It is an “F” shaped block where the main corridor runs across the “L” facing the terraces. The first spaces one encounters are the ward manager and offices to the left, followed by side rooms. Halfway through the corridor on the right projecting onto the terrace, one finds the staff mess room and offices followed by the patients’ common areas where they spend most of their time.

Somerset House is a three storey high building compromising three wards with an identical layout. They are constituted by an “L” shaped corridor with all spaces off to one side. The ward manager is strategically located right where the two wings pivot gaining visual control of the two corridors. Bedford House was built together with Oxford House. It is a one storey high building, east of the main entrance and rather separated from the older buildings located in the middle of the site. Both Oxford House and Bedford House are near the boundary wall. Bedford House compromises Luton ward and the psychology department. All patients at arrival to Broadmoor Hospital go to Luton ward, which is the assessment ward, the 28


most secure ward in Broadmoor. They are then transferred to a different block. The area of the Psychology department also houses treatment areas such as the dental surgery, ECT area, podiatric clinic, X-ray rooms etc. Oxford House is a two storey high building mostly assigned to living areas. There are two wards on each floor. Both wards are identical, with a corridor on each wing and side rooms off both sides. Even though Oxford House is mainly a building for living in, there are a large number of spaces assigned to clinical treatment.

29


Fig 2.13

SITE SELECTION Thorapadi is a part of Vellore Corporation. It is a prominent area in the city of Vellore. It is located at 12.93째N 79.13째E. It has an average elevation of 216 metres. Azad roard is the arterial road of Thorapadi. Thorapadi is 7km from Katpadi Junction Railway Station, 4km from Old Bus terminus, 5km from New Bus Terminus and 3km from Cantonment Railway Station. As of 2001 census, Thorapadi has a population of 14,292. Location

Thorapadi Vellore Tamil Nadu Prison Department Bagayam Road Vellore Tamil Nadu 632002 India 12.886429째N 79.120277째E Building Type No. of Prisoner

Central Prison 2,208

Considering the legal implications and the shared user profile of both the existing jail and the proposed design, it is logical to provide both at proximity to each other for easier access and use. The Thorapadi Jail District consists of various facilities regarding security and area for future expansion. + Located within the Jail District. + Secluded from the loud city life. + Proximity to Warden Training Centre

+ No main road access

30


Fig 2.14 31


BYE - LAWS OPPOSITE ROAD WIDTH SITE AREA PLOT FRONTAGE FRONT SETBACK OVERALL SETBACK OSR

SPACING BETWEEN BLOCKS CORRIDOR WIDTH DRIVEWAY

9m 35000sq.m 12 m 3m 4.5 m 10 % 3500sq.m 6m 2.4m 3.5m

CLIMATE 

Vellore is at 12.92°N 79.13°E, 220m above the mean sea level. The city has a semi-arid climate with high temperatures throughout the year and relatively low rainfall. It is in Vellore district of the South Indian state, Tamil Nadu, 135 km (84 mi) west of the state capital Chennai.

Vellore lies in the Eastern Ghats region and Palar river basin. The topography is almost plain with slopes from west to east.

There are no notable mineral resources. Black loam soil is found in parts of Vellore Taluk. The other type of soil in the city is chiefly gravelly, stony and sandy of the red variety.

Vellore experiences a tropical savanna climate (Köppen climate classification Aw). The temperature ranges from a maximum of 39.4 °C (102.9 °F) to a minimum of 18.4 °C (65.1 °F). Like the rest of the state, April to June are the hottest months and December to January are the coldest. Vellore receives 1,034.1 mm (40.71 in) of rainfall every year.

The site has an average temperature of 32 - 35°, with rains 5 months a year. Wind blows at an average of 10mph throughout the year from east to west and north - east to south - west. 32


33


Fig 2.15

CLIMATE RESPONSIVE STUDY LANDSCAPING

IN-MATES’ GARDENS

Trees that are provided in the open space are required to be such that it does not encourage or permit self-harm tendencies. Trees should not have lowhanging branches, thorns or poisonous sap and fruits. Palm trees must be provided with safety catch-nets to prevent harming of in-mates due to dropping palm fruit. Common Name: Ashoka Tree Plant Height : 12 Plant Spread : 2 Use : accents, street tree, informal screen, windbreak Soil Moisture : dry for extended periods to constantly moist Sunlight : hot overhead sun Origins : India-Subcontinent Seasonality : Evergreen Common Name: Indian Mahogany Plant Height : 12 Plant Spread :6 34


Use Soil Moisture Sunlight Origins Seasonality

: shade, street tree, windbreak, timber : periodical watering : hot overhead sun, partial shade : India-Subcontinent : Sheds in winter for 2 weeks

Common Name: Toddy Palm Plant Height : 30 Plant Spread : 2 Use : accents, fruit, trunks, leaf weaving. Soil Moisture : dry for extended periods to constantly moist Sunlight : hot overhead sun Origins : India-Subcontinent Seasonality : Evergreen Common Name: Coconut Palm Plant Height : 35 Plant Spread : 2 Use : accents, street tree, trunks, leaves , fruit Soil Moisture : dry for extended periods to constantly moist Sunlight : hot overhead sun Origins : India-Subcontinent Seasonality : Evergreen Common Name: Peepal Tree Plant Height : 30 Plant Spread : 15 Use : shade, informal screen, windbreak Soil Moisture : dry for extended periods to constantly moist Sunlight : hot overhead sun Origins : India-Subcontinent Seasonality : Evergreen PASSIVE COOLING Passive cooling is a building design approach that focuses on heat gain control and heat dissipation in a building in order to improve the indoor thermal comfort with low or no energy consumption. This approach works either by preventing heat from entering the interior (heat gain prevention) or by removing heat from the building (natural cooling). Natural cooling utilizes on-site energy, available from the natural 35


environment, combined with the architectural design of building components (e.g. building envelope), rather than mechanical systems to dissipate heat.Therefore, natural cooling depends not only on the architectural design of the building but on how the site's natural resources are used as heat sinks (i.e. everything that absorbs or dissipates heat). Examples of on-site heat sinks are the upper atmosphere (night sky), the outdoor air (wind), and the earth/soil. SURFACE SHADING Surface shading can be provided as an integral part of the building element also. Highly textured walls have a portion of their surface in shade as shown in Figure 5. The increased surface area of such a wall results in an increased outer surface coefficient, which permits the sunlit surface to stay cooler as well as to cool down faster at night. SUN SHADING DEVICES Well-designed sun control and shading devices, either as parts of a building or separately placed from a building facade, can dramatically reduce building peak heat gain and cooling requirements and improve the natural lighting quality of building interiors. The design of effective shading devices will depend on the solar orientation of a particular building facade. For example, simple fixed overhangs are very effective at shading south-facing windows in the summer when sun angles are high. However, the same horizontal device is ineffective at blocking low afternoon sun from entering west facing windows during peak heat gain periods in the summer ROOF SHADING A cover of deciduous plants and creepers is a better alternative. Evaporation from the leaf surfaces brings down the temperature of the roof to a level than that of the daytime air temperature. At night, it is even lower than the sky temperature

36


Fig 2.16

FUNCTIONAL FLOW KITCHEN

37


CRISIS STABILIZATION

38


ECT

Fig 2.17

THERAPEUTIC SPACES 39


A therapeutic environment can be defined as a patient care environment that helps make patients more receptive to the treatment provided by staff. Some who provide services to psychiatric patients feel the built environment where these patients receive services should resemble a “typical residential� atmosphere. Unfortunately, patients from different backgrounds may have entirely different views of what constitutes a home-like setting. A more realistic goal, then, should be to create a non-threatening environment in which patients can feel relaxed and comfortable. Other general hospital elements, such as medical gas outlets, bedpan washers, nurse call systems, and wrist handles on faucet valves, are simply not needed In a psychiatric unit. Windows and window coverings also require special consideration. In the past, very heavy stainless-steel screens were often installed as a safety measure. Although still used in some facilities, these screens provide a very institutional or prison-like appearance. A variety of window glazing materials that cannot be easily broken to produce sharp shards of glass and, if broken, will stay in the frame to resist egress are appropriate for use in psychiatric facilities. Tempered glass breaks into very small pieces that do not stay in the frame; laminated glass will stay in the frame but yields shards. Polycarbonate sheets satisfy both of these requirements.

Fig 2.18

40


SOLUTION & CONCLUSION

Fig 3.1

41


Fig 3.2

42


SVADHYAYA In Sanskrit, sva means “self;” dhyaya translates as contemplating, meditating on or reflecting upon. Svadhyaya refers to any activity wherein we quietly study ourselves and reflect upon our actions, thoughts, emotions, motivations, aspirations, desires and needs in pursuit of a deeper experience of our lives and our own selves. “Svadhyaya therefore can be translated as self-reflection, selfcontemplation or the study of oneself.” Another classical form of svadhyaya is the study of sacred scriptures. This could refer to yogic scriptures, such as the Bhagavad Gita or Yoga Sutras, but could also include any writing that is spiritually revealing and uplifting and which encourages investigation of our own divinity. When we study these works and tap into the wisdom of previous spiritual seekers and sages, we also engage in our own self-examination. These resources can be used as a mirror to reflect the sublime in our own soul. Svadhyaya refers to any activity wherein we quietly study ourselves and reflect upon our actions, thoughts, emotions, motivations, aspirations, desires and needs in pursuit of a deeper experience of our lives and our own selves.

43


ADMINISTRATION AND CRISIS STABILIZATION DESCRIPTION AREA : 2545 SQ.M The Admin block houses three main functions - the administration of the entire facility, security checks on entry and exit and a crisis stabilization unit that handles emergencies within the facility. The Admin block is of three floors with the crisis stabilization unit for only one floor. The entire block is air-conditioned, and the roof is provided with solar panels for additional energy requirements. The Crisis Stabilization unit has a separate entry in the back for easy access from the treatment spaces.

Fig 3.3

GROUND FLOOR 44


FIRST FLOOR

Fig 3.4

45


SECOND FLOOR

ELEVATION A

ELEVATION B

46


Fig 3.5

SECTION A-A’

SECTION B-B’

FORENSIC UNITS DESCRIPTION AREA: 800 SQ.M BEDS: 20 The forensic ward is planned to house mentally-ill offenders or criminals who are admitted to the hospital under law for observation. Separate Ward blocks were required for such patients to safeguard the interests of other patients, and to ensure adequate security provided by the police. The ward planning consists of two independently planned units of 5 beds each. The units are mirror imaged and joined together, resulting in a highly planned symmetrical structure encompassing enclosed and semi enclosed structures. FEMALE WARD


Fig 3.6

SECTION A-A’


Fig 3.7

PLAN

SECTION B-B’

ELEVATION A

ELEVATION B MALE WARD


GROUND FLOOR

FIRST FLOOR

SECTION A-A’

ELEVATION A

TREATMENT SPACES INTERMEDIATE STAY

Fig 3.8


DESCRIPTION

The Intermediate patient’s unit as the name denotes, is meant for the patients who have either improved after a long treatment or their or their treatment involves shorter period of hospitalisation and are likely to be relieved within a few weeks or months. Since the condition of this category of patients is comparatively better their wards are designed to be 3storeys high. Fig 3.9

FEMALE BLOCK

GROUND FLOOR

SECTION A-A’

FIRST FLOOR


ELEVATION A

Fig 3.10

MALE BLOCK


GROUND FLOOR

FIRST FOOR

Fig 3.10

ELEVATION A


SECTION A-A’ Fig 3.11

CHRONIC STAY


DESCRIPTION Chronic Stay Units have been designed to house those chronically ill patients who are unable to sustain lifestyle on their own, and, therefore, need external help to perform their daily chores. Majority of these patients are unlikely to be recovered and hence need hospitalization throughout the remaining part of their life. It is required to provide the patients their exclusive open space/ court for outdoor activities. The Acute care and Chronic stay units have been juxtaposed in such a manner that they enclose adequate space in between.

FEMALE BLOCK: Fig 3.12

PLAN


SECTION A-A’

SECTION B-B’

Fig 3.13

ELEVATION A

ELEVATION B


MALE BLOCK:

Fig 3.14

PLAN

SECTION A-A’

SECTIO N B-B’


ELEVATION A

ELEVATION B

Fig 3.15

ACUTE CARE DESCRIPTION The Acute Care Unit accommodate those mentally-ill patients who are acutely serious and need longer stay and special care in the hospitals. Since these patients are not expected or


capable of moving upstairs their wards have been designed as single- storey. The Male and Female care units are of similar planning, and form is similar to that of Chronic Stay. FEMALE BLOCK

Fig 3.16

PLAN

SECTION A-A’


Fig 3.17

SECTION B-B’

ELEVATION A

ELEVATION B MALE BLOCK


Fig 3.18

PLAN

SECTION A-A’

SECTION B-B’

ELEVATION A

ELEVATION B REHABILITATION CENTRE


DESCRIPTION Occupational therapy and rehabilitation is a vital component in the functioning of a mental hospital. It’s purpose is to train the patient’s in utilizing this time efficiently and productively. This unit has thus been designed to provide important supportive services for the betterment of mentally ill patients. All the training rooms draw sufficient daylight from large fenestrations from the outer periphery. In addition, ventilators have been provided on the inner courtyard side for additional ventilation. Fig 3.19

PLAN

SECTION A-A’

SECTION B-B’


ELEVATION A

ELEVATION B

Fig 3.20

RE-INTEGRATION VILLAGE Occupational therapy and rehabilitation is a vital component in the functioning of a mental hospital. It’s


purpose is to train the patient’s in utilizing this time efficiently and productively. This unit has thus been designed to provide important supportive services for the betterment of mentally ill patients. All the training rooms draw sufficient daylight from large fenestrations from the outer periphery. 1 BHK

Fig 3.21

PLAN

SECTION

ELEVATION 2 BHK


PLAN

Fig 3.22

SECTION

ELEVATION

VILLA


Fig 3.23

PLAN

SECTION

ELEVATION

DESIGN STUDY ACUTE CARE


FORENSIC UNIT

Fig 3.24

CONCLUSION


Psychiatric inpatient facilities present a unique set of challenges, and the solutions to designing safe facilities are often completely different from what is typically done for medical/surgical units in a general hospital. Decisions about design for psychiatric facilities should be thoroughly discussed with facility staff beginning during the programming phase and continuing at decision points throughout a project. As well, the decisions made should be documented, including the reasons behind them, before proceeding to subsequent phases of a project. Space does not allow detailed discussion of solutions to all of the problems mentioned in this paper and, in any case, answers are often very specific to a particular facility. In addition, a product that is perfectly acceptable for one patient population may not be acceptable for another.

REFERENCES Common Mistakes in Designing Psychiatric Hospitals May 2015 James M. Hunt, AIA, NCARB David M. Sine, DrBE, CSP, ARM, CPHRM Healing Landscapes Gardens as places for spiritual, psychological and physical healing


By Kristin Faurest, Ph. ARCHITECTURE FOR PSYCHIATRIC TREATMENT EPFL – École polytechnique féderale de Lausanne Énoncé théorique for the Master Thesis in Architecture, January 2011 Variation to the Master Plan for Vellore Local Planning Area. [G.O.Ms. No. 130, Housing and Urban Development (UD4-1), 14th June 2010.] Ernst and Peter Neufort, Architect’s data


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